Aichi Medical University Hospital, Nagakute, Japan.
MSD K.K., Tokyo, Japan.
Vaccine. 2019 Mar 14;37(12):1651-1658. doi: 10.1016/j.vaccine.2019.01.069. Epub 2019 Feb 20.
The quadrivalent (q) human papillomavirus (HPV) vaccine protects against infection and disease related to HPV types 6, 11, 16, and 18. We report efficacy, immunogenicity, and safety of qHPV vaccine in a Phase 3 study in Japanese men.
In this randomized, double-blind trial (NCT01862874), Japanese men (aged 16-26 years) were randomized in a 1:1 ratio to receive three doses of qHPV vaccine or placebo (Day 1, Month 2, Month 6). The primary efficacy endpoint was the combined incidence of HPV6/11/16/18-related persistent anogenital infection (detected at ≥2 consecutive visits ≥6 months apart), assessed in the per-protocol population of men who received all three vaccinations, and were seronegative at Day 1 and PCR negative from Day 1 to Month 7 to the relevant HPV type. Results are from the interim and final analyses.
In total, 1124 participants were randomized. The vaccine demonstrated 83.3% (95% confidence interval: 24.9, 98.2; p = 0.007) and 85.9% (95% confidence interval: 52.7, 97.3; p < 0.001) efficacy against HPV6/11/16/18-related persistent infection in the interim and final analyses, respectively. Two cases of HPV6/11/16/18-related external genital lesions (condyloma and PIN 1) were observed in the placebo group and none in the qHPV vaccine group at study end. At Month 7, >97% of participants who received qHPV vaccine seroconverted to each of the vaccine HPV types. Most participants remained seropositive at Month 36, although the seropositivity rate declined between Months 7 and 36. Vaccination-related adverse events were reported in 60.8% and 56.5% of participants in the qHPV vaccine and placebo groups, respectively; most commonly mild to moderate injection-site pain, erythema, and swelling. Injection-site pain and swelling were more common with qHPV vaccine than placebo (each p < 0.05).
Results suggest qHPV vaccine is efficacious against HPV6/11/16/18-related persistent infections, immunogenic, and well-tolerated in Japanese men. Clinical trial registration identifier: NCT01862874.
四价(q)人乳头瘤病毒(HPV)疫苗可预防 HPV 型 6、11、16 和 18 相关的感染和疾病。我们报告了在日本男性中进行的一项 3 期研究中 qHPV 疫苗的疗效、免疫原性和安全性。
在这项随机、双盲试验(NCT01862874)中,日本男性(16-26 岁)按 1:1 比例随机分配接受三剂 qHPV 疫苗或安慰剂(第 1 天、第 2 个月、第 6 个月)。主要疗效终点是 HPV6/11/16/18 相关持续性肛门生殖器感染的综合发生率(在至少 2 次连续≥6 个月的就诊时检测到),在接受所有 3 剂疫苗且在第 1 天血清阴性且第 1 天至第 7 天对相关 HPV 型 PCR 阴性的男性中,按照方案进行评估。结果来自中期和最终分析。
共有 1124 名参与者被随机分配。疫苗在中期和最终分析中分别显示出 83.3%(95%置信区间:24.9,98.2;p=0.007)和 85.9%(95%置信区间:52.7,97.3;p<0.001)对 HPV6/11/16/18 相关持续性感染的疗效。安慰剂组有 2 例 HPV6/11/16/18 相关的外生殖器病变(湿疣和 PIN1),而 qHPV 疫苗组无一例。在研究结束时,qHPV 疫苗组>97%的参与者对每种疫苗 HPV 型均产生血清转化。大多数参与者在第 36 个月仍保持血清阳性,尽管在第 7 个月至第 36 个月之间血清阳性率有所下降。qHPV 疫苗组和安慰剂组分别有 60.8%和 56.5%的参与者报告与疫苗相关的不良事件;最常见的是轻度至中度注射部位疼痛、红斑和肿胀。与安慰剂相比,qHPV 疫苗组更常见注射部位疼痛和肿胀(均 p<0.05)。
结果表明 qHPV 疫苗在日本男性中对 HPV6/11/16/18 相关持续性感染具有疗效、免疫原性且耐受性良好。临床试验注册号:NCT01862874。